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目的:探讨超声引导下经直肠微波消融前列腺组织使其体积减小的可行性及安全性。方法:犬麻醉后在超声引导下经直肠对实验犬前列腺的左右两侧叶分别进行微波消融,微波输出能量30 W,作用时间120 s,消融后当天处死动物取出前列腺及周围组织标本,观察消融灶的形态及前列腺周围组织结构有无损伤、测量消融灶体积,最后标本送病理检查。结果:在实验犬前列腺左右两侧叶成功进行了12个点微波消融灶,消融过程中超声图像显示消融区为强回声,范围逐渐扩大,最后热消融区表现为不均质强回声,边界清楚,形态欠规则。大体标本观察:直肠壁穿刺点粘膜下可见少量淤血,局部无热损伤改变,尿道及膀胱壁未见明显热损伤,消融灶呈椭圆形,边界清楚,实测体积为(0.94±0.30)cm3。结论:超声引导下经直肠微波消融前列腺可使局部组织发生凝固性坏死,对前列腺周围重要结构无明显热损伤。二维超声可以实时显示消融区的范围、监控消融过程。
Objective: To investigate the feasibility and safety of ultrasound-guided transrectal microwave ablation of prostate tissue to reduce its volume. Methods: After anesthesia, the dogs were subjected to microwave ablation on the left and right sides of the prostate of experimental dogs under the guidance of ultrasound. The output energy of microwaves was 30 W and the action time was 120 s. The animals were sacrificed on the day after ablation to remove the prostatic and surrounding tissues. The shape of the stove and the tissue around the prostate for damage, measuring the volume of the lesion, the final specimen sent to the pathological examination. Results: 12 points of microwave ablation were successfully performed on both sides of the left and right sides of the canine. The ablation area showed strong echogenicity during the ablation process. The scope of the ablation area was gradually enlarged. In the end, the ablation area showed heterogeneous strong echo and the boundary was clear , Form owed rules. Gross specimen observation: A small amount of congestion was observed under the mucosa at the puncture site of the rectal wall. No local thermal damage was observed. No obvious thermal injury was found on the urethra and bladder wall. The lesion was oval with a clear boundary. The measured volume was (0.94 ± 0.30) cm3. Conclusion: Ultrasound-guided microwave ablation of the prostate tissue can cause coagulation necrosis of the local tissues and no significant thermal damage to the important structures around the prostate. Two-dimensional ultrasound shows the extent of the ablation zone in real time and monitors the ablation procedure.